Therapists strive to create both a trusting relationship and a comfortable environment with all their clients. Today, clients seeking therapy come from an array of backgrounds, requiring therapists to know and understand the various ways culture impacts the therapeutic relationship. Cultural competence is defined by: The capacity to increase one’s understanding and knowledge of cultural differences, the ability to acknowledge cultural assumptions and biases, and the willingness to make changes in thoughts and behaviors to address those biases.

Culturally competent therapists must reach within and explore their own capabilities as clinicians. They must explore their own identities and attitudes towards working with different groups, including the LGBTQ (Lesbian, Gay, Bi-sexual, Transgender, and Queer) communities to prevent skewed counter-transferential views from adversely affecting therapeutic outcomes. Therapists often reflect on their own cultural identity and self-awareness with the understanding that these are the necessary ingredients needed for one to be a culturally competent therapist.

Cultural competence is an ongoing process of examination and change, not a goal to be attained once. Culturally competent clinicians contemplate on an ongoing basis what life is like for people different from themselves. They embody inquisitive and open-minded attitudes toward other cultures and how other aspects of diversity play into the therapeutic process. While culturally competent clinicians account for clients’ varying cultural identities they must also be sensitive to diversity without simultaneously stereotyping. It is unreasonable to expect that textbooks, articles, or videos will tell us all (or a majority) of what we need to know. It is imperative that therapists understand the nuances of cultural diversity, on issues of power, privilege, and marginalization and the impact of these constructs on the experiences of clients from diverse backgrounds.

Since cultural self-awareness is difficult to foster and evaluate, clinicians must strive to create a safe space for clients to openly share and explore their cultural similarities and differences. Therapists may also come to realize that not all individuals will benefit from a particular model of therapy due to cultural factors. Since cultural self-awareness is difficult to foster and evaluate, the clinician must strive to create a safe space for clients. Two integral parts of a multicultural competent clinician include humility and critical thinking. One must be humble enough to identify one’s own skills and challenges without bias, as well as be able to challenge one’s own assumptions. By appreciating a client's culture, therapists can tap into the most effective treatment strategies—those based on the personal and social strengths of each individual.